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04-105066 ►s p , City of Federal Way Mechanical Permit #: 04 - 105066 - 00 - ME Community Development Services PO.Box 9718 Federal Way,WA 98063-9718 Ph (253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050 Project Name: PARFINSKI �'Jv Project Address: 28834 23RD"S Parcel Number: 422250 0200 Project Description: Replace old gas furnace with new Owner Applicant Contractor Gary Parfinski DICK'S HEATING AND A/C INC. DICK'S HEATING AND A/C INC. 1516 45TH ST E SUITE 200 1516 45TH ST E SUITE 200 SUMNER WA 98390 SUMNER WA 98390 (253)531-9579 Mechanical Valuation 1975 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity Furnaces 1 PERMIT EXPIRES June 13,2005. Permit issued on December 15,2004 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Federal Wa . Owner or agent: Date: / /. —O Y )/(erp THIS CARD IS TO REMAIN ON-SITE , CITY Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 04-105066-00-ME Owner: GARY PARFINSKI Address: 28834 23RD AVE S FEDERAL WAY, WA 98003-7922 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. 0 Mechanical Rough-in(4165) 0 Gas Piping(4125) 0 Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By ri,. Date (2.—2 -o y ii .c,Ff?4345TWED RECEivEn ctry nv 1��12�O�Or ULA 1 5 2004 04 _ __[ _6 _0 k _co Federal Way ] OFF ., ; . •% , - �` Lb/ND6RAt MAY SF MFC EL PL DE EN FP COMMUNITY DEVELOPMENT SERVICES�''( �v�{'1• • 'r- 3332FEDERAL WAYSW�8.0690189 ' D114 �A••�.'ft,* •� LI CATI Off`'( TD 253-835-2607•FAX 253-835-2609 y°11. / www crtua(federalwau corn The ollowin• is re•uired in ormation-an incom•tete a••lication will not be acce•ted. Please •rint le•ibl in ink or •e. C • PROPERTY INFORMATION SITE ADDRESS ��6 3 Li .7 3 Rjz 4Ve• 5 " SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - LOT SIZE(s}) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal descnphon) ■ PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING 0 PLUMBING ECHANICAL ❑ DEMOLITION 0 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) IQe p 1 ACo ©id Cats Cut uct e __ to i c iv e c e9 PROJECT NAME(Name of Business or Owner Last Name) • PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER 4%'Art ct 9'n Cc-tcf NS t ( 3 ) 9'/( `-(o°Z_ MAILING ADDRESS CITY,STATE,ZIP SSs .? 324 ,3t�Ave 5, ft;dePal&xi. , l,�/A- eiVoo CONTRACTOR COMPANY Nfiats au a APPLICANT NAME O OFFICE PHONE ``�j (0253)5"3/ - S5-7GI MAILING ADDRI1v�St RSIB 300 CITY,STATE,ZIP CELL PHONE SU WA NMI ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER / / ( ) - - - -B L CONTRACTOR'S REGISTRATION NUMBER(copy of carrequired ith each application( EXPIRATION DATE t1 CK ST f 2 Lq_ L 7 / 5-- / c- APPLICANT COMPANY NAME / APPLICANT NAME OFFICE PHONE ADDRESS �+ t.c, Q RN S '� - > ( ) MAILING ADD CITY,STATE,ZIP CELL PHONE 540e. G-5 A PSnue- ( ) RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect tenant 0 Agent ❑ Other(Describe) ( ) CONTACT NAME (��124 /, r���t • PRIMARY PHONE - E-MAIL ADDRESS �� LENDER Per RCW 19.27.095: Lender information is (I NAME required?f project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES o NO WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) ,A • 40. • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE D CARPORT❑ NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTALS? **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL , ee--- Value of Mechanical Work $ 1 iJ /Z AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(cammermrl) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS / FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS(Toile) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAYS(Bathroom Smke) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE :� `� DATE (Signatu (Title) RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ontractor 0 Architect 0 Other FOR OFFIC,,:USE:ONLX, :W ❑NEW ❑ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO ZONING DESIGNATION CHANGE OF USE? a YES o NO NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? ❑YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—August 19,2004 Page 2 of 4 k\Handouts\Permit Application